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2,3] The cardinal sign in habitual dislocation is that if the patella is forcibly held in the midline it is not possible to flex the knee more than 300 to 700.
7] This association of quadriceps contracture with habitual dislocation was later confirmed by Gammie (1963), Lloyd-Roberts and Thomas (1964), Williams (1968) and Alvarez et al (1980).
In habitual dislocation of the patella, if full flexion is not possible by keeping patella in trochlea, quadriceps contracture should be considered and in these cases, the addition of V-Y quadricepsplasty to the proximal realignment surgery (lateral release and medial plication) will provide excellent result.